肠道菌群的共生素调节对肝硬化患者亚临床肝性脑病影响

目的探讨肠道菌群的共生素(海斯药业,贝飞达)调节对肝硬化患者亚临床肝性脑病(SHE)的治疗作用和机制。方法50例慢性乙型肝炎后肝硬化(代偿期)SHE患者随机分为治疗组(25例)和对照组(25例)。治疗组在对照组治疗的基础上给予贝飞达胶囊2粒,3次/日,对照组给予一般类保肝药,疗程8周。观察治疗前、后第4、8周患者临床症状、体征、肝功能、血氨、内毒素(LPS)、数字连接实验(NCT)、Child-Turcotte-Pugh功能分级、肝性脑病(HE)的发生等指标变化,并与对照组比较。结果贝飞达不仅可改善临床症状、体征、肝功能、Child-Turcotte-Pugh功能分级,而且明显降低血氨、内毒素和数字连接试验的时间(P<0.05)。结论共生素调节能有效地改善肝硬化患者亚临床肝性脑病(SHE)和避免肝性脑病(HE)发生,其机制可以是通过降低血氨、通过调整肠道菌群失调降低内毒素等减轻肝脏炎症,改善肝功能,从而降低HE的发病率。

The Effects of the Regulation by Intestinal Probiofics and Fermantative Microflora on the Subclinical Hepatic Encephalopathy(SHE) of the Patients with Hepatocirrhosis

Objective To investigate the therapeutic effect and its mechanisms on the treatment of subclinical hepatic encephalopathy(SHE)caused by hepatocirrhosis(compensatery phase)due to hepatitis B by Bifido(Haisi pharmacy).Methods 50 cases were randomized into therapeutic group and control group wtih twenty-five patients each.Patients in therapeutic group were given Bifido two capsule pills t.i.d in addifion to conventional therapy,while patients in controgroup were given the conventional therapy namely soft food with low salt,protective drugs for liver and supporting therapy.The therapeutic course in two groups was 8 weeks.We observed the changes of clinical symptoms,signs,arterial blood ammonia level,hepatic functions,number connection test(NCT) and other indexes prior to treatment and 4,8 weeks after treatment.Results It showed that Bifido capsules could not only improve the clinical symptoms,signs,Child-Turcotte-Pugh function grade,but also could decrease arterial blood ammonia,LPS level and time of number connection fest and the occurrence of HE(P<0.05) in therapeutic group.Conclusions Bifido capsules can improve SHE resulting from hepatocirrhosis obviously and avoid the occurrence of HE,and the mechanism may improve liver function through decreasing blood ammonia and defecation of remove endotoxin to relieve hepatic inflammation.